WWe all want a cure for Covid-19, but it won’t come in one drug. We also cannot hope to escape this global crisis if treatments, tests or vaccines are not made available to the world’s most vulnerable people. There is still a lot to do.
Solid research has shown that hydroxychloroquine, the drug once heavily promoted by Donald Trump, does not work as a treatment. We look forward to the first vaccines, but we have to be realistic: they can only offer partial protection, important as that is. Now, as the US President puts his hopes on Regeneron’s cocktail of antibodies, it must be clear: life can only return to normal with a range of clinically proven and effective treatments, tests and vaccines; resilient health systems to provide them; and public confidence.
Over a million people have lost their lives to the virus in just 10 months, and every day still brings a daily record of new cases. Others suffer from the “long Covid” and its debilitating long-term effects. In the UK, as we move into winter, hospitalizations due to Covid-19 increase and a new three-tier mini-lock system is introduced, we urgently need a range of high-level treatments. quality to protect people.
Though catapulted into the limelight thanks to Trump’s diagnosis, treatments have often been overlooked in favor of coveted vaccines. To date, $ 2 billion (£ 1.5 billion) has been invested in vaccines – six times more funding than treatments. Yet the world needs $ 7.2 billion just for effective treatments, without which millions of more lives remain at risk. That’s a lot of money, but with a global economy expected to contract by $ 12 billion in 2020 alone, that’s a fraction of what we are currently losing every day.
Currently, there is only one proven treatment that reduces mortality from Covid-19: dexamethasone. This widely available and affordable steroid has been used safely for decades and may improve survival when used in hospitalized patients with Covid-19 who require oxygen or are ventilated. But it doesn’t work in patients not on oxygen. We also know that remdesivir, an antiviral drug, can help speed recovery in critically ill patients, reducing the average hospital stay by about four days.
It’s no surprise that months of research have led to so few treatments. We still expect many tries to fail. Our best short-term chance has been to explore whether existing drugs have any benefits – by trying everything from antimalarial drugs to those used to treat arthritis. They are safe, affordable and easy to produce around the world. If they are effective against Covid-19, we can ensure that they will be accessed by those who need them most in a matter of weeks.
For example, less than 20 days after dexamethasone was identified as a treatment (by the UK-based Recovery trial), Unitaid, the World Health Organization and Wellcome through the global ACT-Accelerator partnership have got 2.9 million courses of treatment for income countries. The partnership is ready to act immediately if there is clear evidence of new, safe and effective treatments.
We need to be realistic about what we can expect from reusing drugs designed for other diseases, but we still need to exhaust all options.
Finding treatments that work at all stages of the disease – especially mild and moderate cases to stop the progression to more serious disease – would be a game-changer. In the limelight last week, monoclonal antibodies, the first treatments specifically for Covid-19, may well be one of them.
Trump has touted the benefits of Regeneron’s experimental monoclonal antibody cocktail, which has yet to complete its final clinical trials. Eli Lilly monoclonal antibody therapy also looks very promising. If successful, these could dramatically reduce the likelihood of mild symptoms becoming severe and save lives for people with severe illness. The potential is enormous.
For 30 years, monoclonal antibodies have transformed the way doctors treat, prevent and cure serious noncommunicable diseases, including cancers and autoimmune diseases: Last year, seven of the top 10 new drugs were monoclonal antibodies. for cancer and inflammatory diseases. But they are traditionally among the most expensive treatments in the world: 80% are sold in the United States, Europe and Canada, and little, if any, are available in low- and middle-income countries.
Covid-19 should be the catalyst to reduce the prohibitive cost of these drugs and make them accessible to everyone. It will require new ways of thinking, technological innovation, new types of collaboration and commerce, but I am confident that universities, industry and governments around the world can find solutions together. This could transform treatment for Covid-19, but also ensure that the monoclonal antibody class of drugs is globally accessible and affordable for many diseases.
As the UK enters a critical winter, we need to take stock of the many strides made since the start of the year. The medical staff now have experience with this disease: they know how to position patients, how to use fluids, how to stop blood clotting and when to use ventilators. Their knowledge will prove invaluable as more and more people are admitted to hospital.
On their own, these measures and treatments will not be a quick fix. But together, combined with first-generation vaccines and essential public health measures to reduce transmission, they give us every reason to be hopeful. In the near future, Covid-19 will be a preventable and treatable disease. We need to make this true for everyone, wherever they live or however wealthy they may be. And whether they are president or not.